Award-Winning Michigan Neonatal Brain Injury Lawyers & Cerebral Palsy Attorneys Helping Children Affected by Brain Injuries, Cerebral Palsy & Other Birth Injuries | Serving Clients in Michigan & All 50 States
When a child with cerebral palsy (CP) or special needs is able to ride a bike for the first time, it can be life-changing. Beaumont hospitals of Royal Oak, Troy, Farmington Hills, Macomb, and Shelby Township, Michigan are part of a nationwide organization that gives special bikes to children with cerebral palsy so they can ride like other kids. Every year, Beaumont Hospital partners with Children’s Miracle Network to give away hundreds of custom bikes in Michigan.
A girl named Ali from Royal Oak got her first bike at age 12 at Beaumont’s Bike day. She was born with a seizure disorder and diagnosed with cerebral palsy shortly after birth. The cerebral palsy causes Ali to have severe balance problems because her muscles don’t work together. Her custom mountain bike was specially made to help her legs work together. Ali says she is now able to ride with her friends at the park “and it feels awesome.”
Ali’s mother, Cheryl says that the cost of a custom bike, which can be $3,500.00 or more, put the idea of a bike out of reach for the family. Ali’s medical needs are very costly. In addition to leg braces and other medical devices, the family has to pay high co-pays for Ali’s seizure medication.
The bike fits Ali perfectly and is purple, which Cheryl says makes her look really cool. It was created to give Ali room to grow. Ali’s parents hope that if Ali spends a lot of time doing physical therapy and riding her bike, which is a three-wheeler, she can eventually learn to ride a two-wheeler. Most custom bikes for children with cerebral palsy are tailor made for each child’s specific needs; even children who have no use of their legs can have a bike custom-made.
NATIONALLY RECOGNIZED MICHIGAN CEREBRAL PALSY LAWYERS HELPING CHILDREN FOR ALMOST 3 DECADES
The award-winning lawyers at Reiter & Walsh ABC Law Centers have helped hundreds of children affected by hypoxic ischemic encephalopathy and cerebral palsy. Michigan attorney Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy. Partners Jesse Reiter and Rebecca Walsh are currently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The attorneys at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ). In fact, Jesse is one of only 2 attorneys in Michigan to have been elected Chair of the BTLG.
If your child experienced a birth injury such as HIE, seizures, cerebral palsy or any other long-term condition, contact Reiter & Walsh today at 888-419-2229. Our award-winning Michigan cerebral palsy attorneys are available 24/7 to speak with you.
CYCLING THERAPY FOR CHILDREN WITH CEREBRAL PALSY
Research shows that bicycling and cycling therapy provide significant benefits for children with cerebral palsy, yet insurance does not cover the cost of custom-made bikes. Indeed, cycling therapy builds muscle tone and cardiovascular strength and it helps improve a child’s motor function, range of motion, balance and coordination. Over time, bicycle therapy can help the child counteract muscle deterioration and overcome specific disabilities. Studies show that cycling therapy is most effective when put into practice at least 2 times per week for 20 – 30 minutes each day. A physical therapist should be consulted to plan an exercise regime that’s specific to the child’s body type and abilities.
Children with cerebral palsy that are new to cycling therapy must spend time getting accustomed to using a modified bicycle. It is common for new bicycle users to expend too much energy and overuse muscle groups unrelated to the activity because they have muscles that involuntarily contract and activate together. A physical therapist can help identify and target these automatic actions.
TYPES OF BIKES FOR CEREBRAL PALSY CYCLING THERAPY
Most children begin cycling through the use of a tricycle. Some children with cerebral palsy may never graduate from the stability of a three-wheeler, but modern tricycles will take even the oldest children around the block in style. For younger children, there are a variety of tricycles with adaptive supports. These include self-leveling pedals with straps, dual axle systems to reduce resistance and make pedaling easier, adjustable body support, and specialized handlebars for easy control.
Children with vision and other problems may require the assistance of a person who can ride a bicycle. Modern tandem bicycles, either two wheel or three wheel, allow the child to sit up front. The person in back can control all the important functions of steering, braking and gearing. The child can then pedal and enjoy the ride.
Hand Crank Bicycle & Tricycles
Many bicycles and tricycles can be fitted with hand crank systems that allow a child to ride without the use of her legs. For a child with limited leg use, some bikes can be created to allow combined hand and pedal power. Bicycles can also be modified with one-hand controls, shifter and brake adapters, seat belts, safety harnesses and electric motors.
Custom Built Bicycles
There are numerous ways in which a bike can be custom made to work with a child’s disability. Bicycles and tricycles can be built to accommodate varying heights, paraplegia and other challenges.
Young children love riding in bicycle trailers pulled behind a bike. Trailer options are available for children with cerebral palsy of all ages. A peditruck allows somoene to pull a trailer with a wheelchair-bound child. The trailer includes a ramp and tie downs for easy access and safety. These bikes can be equipped with an electric assist to help pull the added weight of the wheelchair.
WHAT IS CEREBRAL PALSY & WHAT CAUSES IT?
Cerebral palsy is a group of disorders that cause a child to have problems with movement, posture, balance and coordination. It is caused by a brain injury while the brain is still developing, which means a child can get cerebral palsy until approximately 3 years of age, although sometimes CP isn’t recognized until the child is 4 or 5 years old, when certain developmental milestones are missed.
Spastic cerebral palsy is by far the most common type of CP. Normally, muscles coordinate in pairs; when one group of muscles tighten, the other group relaxes. This allows free movement. In spastic cerebral palsy, complications in brain-to-nerve-to-muscle communication occur and the balanced degree of muscle tension is disrupted. Muscles affected by spastic CP become active together, which prevents coordinated movement. Thus, the muscles in children with spastic cerebral palsy are constantly stiff or spastic.
Often, cerebral palsy is caused by an injury that occurs during or near the time of birth, called a birth injury. A lack of oxygen to the baby’s brain, called birth asphyxia, is a common cause of CP. Conditions that can cause birth asphyxia and cerebral palsy include umbilical cord prolapse and nuchal cord (cord wrapped around the baby’s neck), placental abruption, uterine rupture and delayed emergency C-section when the baby is in distress.
Brain bleeds (intracranial and extracranial hemorrhages) and infection in the mother that travels to the baby at birth can also cause cerebral palsy. Forceps and vacuum extractors are a common cause of brain bleeds. Group B strep and herpes in the mother can infect the baby at birth and cause meningitis, which can lead to cerebral palsy.
HOW IS CEREBRAL PALSY TREATED?
There are numerous surgeries, medications, treatments and therapies that can significantly improve the symptoms of cerebral palsy. Intense physical therapy, playing sports, riding horses, attending special camps and riding specially made bikes have all been shown to provide significant social, emotional and physical benefits for people with special needs. Having medical and therapeutic experts involved in the treatment of a child with cerebral palsy is crucial. In addition, social interaction and a sense of community are very important for kids with CP, and when these children can work with experts and do fun activities with other special needs children, the benefits are immeasurable.
The goal of physical therapy is to promote motor and developmental skills. Daily range-of-motion (ROM) exercises are important to prevent or delay contractures that are caused by spasticity and to maintain the mobility of joints and soft tissues. Stretching exercises are done to increase range of motion, and progressive resistance exercises should be taught in order to increase strength. The use of age-appropriate play and of adaptive toys and games based on the desired exercises are important in order to make the therapy fun. Strengthening knee extensor muscles helps to improve crouching and stride length. Postural and motor control training is important and should follow the developmental sequence of normal children; head and neck control should be achieved, if possible, before advancing to lower body control.
Children and their parents often enjoy hippotherapy (horseback-riding therapy) to help improve the child’s muscle tone, ROM, strength, coordination, and balance. Hippotherapy offers many social, cognitive, physical, and emotional benefits.
Electrical stimulation of weakened muscles is usually tolerated well in older children and can help strengthen muscles and maintain muscle size. In a child with weak dorsiflexors (muscles in the lower leg that act on the foot) that are causing foot drop or tripping, for example, electrical stimulation to the shin muscle could be beneficial.
Physical therapy is crucial when a child has had surgery to help correct spasticity; it helps the child obtain maximum benefit from surgery.
Occupational therapy for children with cerebral palsy should focus on daily life activities, such as feeding, dressing, toileting, grooming, and transfers. Occupational therapy also focuses on the upper body. The goal should be for the child to function as independently as possible with or without the use of adaptive equipment.
Children who can follow directions and have spasticity of certain muscles in the wrist, forearm, or muscles that control the thumb may benefit from intensive therapy. Activity-based interventions such as modified constraint-induced movement therapy (mCIMT) and bimanual intensive rehabilitation training (IRP) can improve the child’s ability to use the impaired upper limb(s) and improve performance in personal care. One study found that more benefits were seen from intensive treatment than in the standard treatment; in mCIMT, grasp improved, and, in IRP, spontaneous use in bimanual play and activities of daily living in younger children increased.
Some children with cerebral palsy have involvement of the face and upper airway, causing drooling and difficulty swallowing and speaking. Speech therapy can be used to help improve swallowing and communication. Some children benefit from assistive communication devices if they have some motor control and adequate cognitive skills.
Incorporation of play into a child’s therapy program is very important so the child stays interested. The child should view physical and occupational therapy as fun, not work. Caregivers should seek fun and creative ways to stimulate children, especially those who have a decreased ability to explore their own environment.
Recreational activities that can help fitness include hippotherapy, sports, cycling, water therapy and special camps created for special needs children.
If the child with cerebral palsy has seizures, the treatment is based on the type and frequency of the seizures. Complete seizure control can often be achieved using a single medication, but some children with cerebral palsy have particularly difficult-to-control seizures. Medication can have side effects affecting the brain, ranging from sedation to hyperactivity. The goal of the physician should be for the child to become seizure free with few or no side effects.
The treatment of spasticity should involve multiple health professionals. Treatments include the use of medications and surgical procedures to decrease spasticity, facilitate movement, and prevent contractures. Among the most common medications are dantrolene sodium (Dantrium) and diazepam (Valium). Diazepam is both a muscle relaxant and a sedative. The most common complications with these medications are drowsiness, sleepiness, and some degree of weakness. The sedative side effects of such medications often limit their usefulness. In the case of the baclofen pump, the most common complication is infection at the site of the catheter. Additionally, a muscle relaxing agent called botulinum toxin (Botox) can be injected into tight muscles to relax them.
Selective Dorsal Rhizotomy (SDR)
Selective dorsal rhizotomy (SDR) is surgery that is performed on the lower spinal cord to reduce spasticity in the legs. During SDR, physicians carefully identify and test the sensory nerves to see exactly which ones are misfiring. The misfiring nerves are then cut. This provides long-term improvement in muscle tone because the nerves do not grow back together.
The goal of SDR is to relax the muscles by identifying and cutting only those nerve fibers that contribute to spasticity. When it is followed by months of rehabilitation, SDR can improve the child’s ability to move and control her muscles. SDR may reduce the need for future orthopedic surgeries.
In this procedure, physicians place a pump about the size of a hockey puck in the child’s abdomen. The pump continuously delivers a medicine called baclofen into the fluid surrounding the child’s spine. Baclofen is a muscle relaxant that reduces spasticity throughout the child’s body. Since the medicine goes directly into the nervous system, the dose of baclofen the child gets through the pump can be much lower than doses delivered through the mouth. This helps avoid the side effects of higher doses, which include sleepiness and sedation.
During surgery, the pump is placed under the skin of the child’s abdomen. Once the pump is in place, the physician attaches a catheter to it. Then the physician threads the catheter under the skin at waist level to the child’s spine. The catheter is inserted into the spinal canal.
Next, the physician fills the pump with baclofen and sets it to deliver the exact amount of medicine the child needs. The pump begins slowly releasing the medicine through the tube and into the spinal canal.
The baclofen pump must be filled with medicine every one to six months, depending on the child’s dose. The pump lasts about five years. Afterward, it must be removed and replaced during another surgery.
Tendon Release Procedures
Tendon release surgery allows improved range of motion in some cases. The surgery is usually performed on the muscles of the calf or inner thigh.
Tendon release is a procedure to cut through or disconnect a tendon (tenotomy.) The surgery normally involves cutting the tendon and allowing it to retract towards the junction of the muscle and tendon. The purpose of tendon release is to identify and surgically remove the area producing symptoms, while protecting the normal surrounding tissues and their attachments.
Tendon release is commonly done to relieve tightened or shortened muscles (contractures), allow relaxation of joints, and decrease irritation caused by friction. Sometimes the tendon is re-routed to maintain muscle function.
REITER & WALSH: MICHIGAN NEONATAL BRAIN INJURY LAWYERS & CEREBRAL PALSY ATTORNEYS
If you are seeking the help of a birth injury lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases. Reiter & Walsh ABC Law Centers is a birth injury law firm that has been helping children throughout the nation for almost 3 decades.
Michigan cerebral palsy lawyer Jesse Reiter, president of the firm, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy. The partners of the firm, Mr. Reiter and Rebecca Walsh, were recently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015. In fact, U.S. News and World Report has given Mr. Reiter the honor of being one of the “Best Lawyers in America” every year since 2008. The neonatal brain injury lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with a birth injury such as hypoxic ischemic encephalopathy (HIE), brain damage, cerebral palsy, periventricular leukomalacia (PVL), a seizure disorder or developmental delays, the award-winning Michigan cerebral palsy attorneys at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized Michigan law firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our award-winning neonatal brain injury lawyers are available 24 / 7 to speak with you.